Patient functional independence and occupational therapist time-use in inpatient services: Patient demographic and clinical correlates.
Bianca E Summers, Kate E Laver, Rebecca J Nicks and 4 others
PMID 34987345WHAT IT FOUND
Across 4549 inpatient admissions, lower functional independence was associated with more occupational therapy time, but the amount varied by hospital site.
Patient and situational factors alone did not capture enough of therapist workload to support ratio-based workforce planning.
Key findings
01Across the hospital network, each unit decrease in SMAF score was associated with a 3.5-minute increase in median occupational therapy time across admission.
02The association varied by site: a 2.2-minute increase at the acute site, a 13.2-minute increase at the rehabilitation site, and a three-minute increase at the community site for each unit decrease in SMAF score.
03The authors stated the model was not sufficiently informative to recommend its use in developing more extensive occupational therapy workforce planning models.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The time-use data were self-reported by occupational therapists and entered retrospectively, so recall bias may make the minutes inaccurate. Multimorbidity and allied health assistant time were not included because diagnostic coding and time-use data were too complex at the study sites. The model was not informative enough to recommend for extensive workforce planning. The study covered three sites within one public hospital network, so organisational culture may not match other services. Patients who died in hospital, outlier time-use episodes and admissions without a complete SMAF assessment were excluded, so very complex or missing cases are not represented.
Declared interests
The authors declared no potential conflicts of interest. The project did not receive funding. Authors were supported by a NHMRC-ARC Dementia Research Development Fellowship, an NHMRC Scholarship, and the Alfred Health Occupational Therapy Department.
The easy way to misread this
Do not read these associations as proof that staffing ratios can be set from SMAF scores. The authors said the model was not sufficiently informative for workforce planning, and time-use varied by hospital site and by diagnosis, so one ratio would not fit all settings.